Tags

Type your tag names separated by a space and hit enter

Early two-stage double opposing Z-plasty or one-stage push-back palatoplasty?: comparisons in maxillary development and speech outcome at 4 years of age.
Ann Plast Surg. 2011 Feb; 66(2):148-53.AP

Abstract

Determining the optimal timing and procedure of palatal surgery for children with cleft lip and palate has long raised a major controversy. An early two-stage palatoplasty protocol has been a recent trend in an attempt to obtain preferable maxillary growth without compromising adequate speech development. In this study, we aim to address whether the resulting maxillofacial growth and speech development obtained by an early 2-stage palatoplasty protocol are better than those obtained by conventional 1-stage push-back palatoplasty. Seventy-two nonsyndromic children with complete unilateral cleft lip and palate were enrolled in this study. They were divided into 2 groups: 30 children, who were treated with early 2-stage palatoplasty, in which soft palate closure was performed using a modified Furlow's procedure at 12 months of age and hard palate closure was performed at 18 months of age (Early Tow Stage [ETS] group: 22 boys, 8 girls), and 42 children, who underwent 1-stage Wardill-Kilner push-back palatoplasty at 12 months of age (Push Back [PB] group: 31 boys, 11 girls). Cephalometric analysis for maxillofacial growth and assessments of speech development were performed for each child at 4 years of age. The ETS group showed a lager maxillary length than the PB group [anterior nasal spine (ANS)-ptm': ETS, 46.7 ± 2.0 mm; PB, 43.6 ± 2.3 mm]. The ANS in the ETS group was positioned more anteriorly than that in the PB group (N'-ANS: ETS, 2.5 ± 1.8 mm; PB, 0.26 ± 2.5 mm), whereas the posterior edge of the maxilla positioned anteroposteiorly was comparable between the 2 groups. The anterior facial height was significantly greater in the ETS group than in the PB group (N-N': ETS, 43.3 ± 2.9 mm; PB, 40.1 ± 2.3 mm, S-S': ETS, 29.7 ± 3.2 mm; PB, 31.0 ± 3.2 mm). No statistically significant differences were observed in the incidence of either velopharyngeal incompetence or articulation errors between the 2 groups at 4 years of age. Our results show that the early 2-stage protocol is advantageous with regard to maxillary growth compared with 1-stage push-back palatoplasty without compromising speech development as evaluated for all children at 4 years of age.

Authors+Show Affiliations

Department of Oral and Maxillofacial Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21042187

Citation

Yamanishi, Tadashi, et al. "Early Two-stage Double Opposing Z-plasty or One-stage Push-back Palatoplasty?: Comparisons in Maxillary Development and Speech Outcome at 4 Years of Age." Annals of Plastic Surgery, vol. 66, no. 2, 2011, pp. 148-53.
Yamanishi T, Nishio J, Sako M, et al. Early two-stage double opposing Z-plasty or one-stage push-back palatoplasty?: comparisons in maxillary development and speech outcome at 4 years of age. Ann Plast Surg. 2011;66(2):148-53.
Yamanishi, T., Nishio, J., Sako, M., Kohara, H., Hirano, Y., Yamanishi, Y., Adachi, T., Miya, S., & Mukai, T. (2011). Early two-stage double opposing Z-plasty or one-stage push-back palatoplasty?: comparisons in maxillary development and speech outcome at 4 years of age. Annals of Plastic Surgery, 66(2), 148-53. https://doi.org/10.1097/SAP.0b013e3181d6e426
Yamanishi T, et al. Early Two-stage Double Opposing Z-plasty or One-stage Push-back Palatoplasty?: Comparisons in Maxillary Development and Speech Outcome at 4 Years of Age. Ann Plast Surg. 2011;66(2):148-53. PubMed PMID: 21042187.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early two-stage double opposing Z-plasty or one-stage push-back palatoplasty?: comparisons in maxillary development and speech outcome at 4 years of age. AU - Yamanishi,Tadashi, AU - Nishio,Juntaro, AU - Sako,Michiyo, AU - Kohara,Hiroshi, AU - Hirano,Yoshiko, AU - Yamanishi,Yukiko, AU - Adachi,Tadafumi, AU - Miya,Shigenori, AU - Mukai,Takao, PY - 2010/11/3/entrez PY - 2010/11/3/pubmed PY - 2011/5/27/medline SP - 148 EP - 53 JF - Annals of plastic surgery JO - Ann Plast Surg VL - 66 IS - 2 N2 - Determining the optimal timing and procedure of palatal surgery for children with cleft lip and palate has long raised a major controversy. An early two-stage palatoplasty protocol has been a recent trend in an attempt to obtain preferable maxillary growth without compromising adequate speech development. In this study, we aim to address whether the resulting maxillofacial growth and speech development obtained by an early 2-stage palatoplasty protocol are better than those obtained by conventional 1-stage push-back palatoplasty. Seventy-two nonsyndromic children with complete unilateral cleft lip and palate were enrolled in this study. They were divided into 2 groups: 30 children, who were treated with early 2-stage palatoplasty, in which soft palate closure was performed using a modified Furlow's procedure at 12 months of age and hard palate closure was performed at 18 months of age (Early Tow Stage [ETS] group: 22 boys, 8 girls), and 42 children, who underwent 1-stage Wardill-Kilner push-back palatoplasty at 12 months of age (Push Back [PB] group: 31 boys, 11 girls). Cephalometric analysis for maxillofacial growth and assessments of speech development were performed for each child at 4 years of age. The ETS group showed a lager maxillary length than the PB group [anterior nasal spine (ANS)-ptm': ETS, 46.7 ± 2.0 mm; PB, 43.6 ± 2.3 mm]. The ANS in the ETS group was positioned more anteriorly than that in the PB group (N'-ANS: ETS, 2.5 ± 1.8 mm; PB, 0.26 ± 2.5 mm), whereas the posterior edge of the maxilla positioned anteroposteiorly was comparable between the 2 groups. The anterior facial height was significantly greater in the ETS group than in the PB group (N-N': ETS, 43.3 ± 2.9 mm; PB, 40.1 ± 2.3 mm, S-S': ETS, 29.7 ± 3.2 mm; PB, 31.0 ± 3.2 mm). No statistically significant differences were observed in the incidence of either velopharyngeal incompetence or articulation errors between the 2 groups at 4 years of age. Our results show that the early 2-stage protocol is advantageous with regard to maxillary growth compared with 1-stage push-back palatoplasty without compromising speech development as evaluated for all children at 4 years of age. SN - 1536-3708 UR - https://www.unboundmedicine.com/medline/citation/21042187/Early_two_stage_double_opposing_Z_plasty_or_one_stage_push_back_palatoplasty:_comparisons_in_maxillary_development_and_speech_outcome_at_4_years_of_age_ L2 - https://doi.org/10.1097/SAP.0b013e3181d6e426 DB - PRIME DP - Unbound Medicine ER -